Out of Options: Hand Surgery Saves Fingers and Function


For several years, Melissa Warde endured disabling pain in her fingers, caused by an autoimmune system disease. She found some relief in medication, but the disease progressed, constricting blood flow to her hands so badly that amputation became a strong possibility. The surgery she had at Stanford Hospital changed all that.

This procedure is becoming a very much desired procedure for scleroderma patients, but you need a vascular surgeon who has the experience.

-Lorinda Chung, MD, Director, Stanford Hospital rheumatologist

Melissa Warde shows her Stanford plastic sugeon, James Chang, the changes in her hand since surgery.

I started to get these ulcers on my fingers that wouldn't heal and I was in danger of losing my fingers.

-Melissa Warde, patient, Stanford Hospital & Clinics

Stanford hand surgeon James Chang is one of a very small group of physicians with the technical expertise to successfully perform a surgery like Warde's. Called a digitial sympathectomy, the surgery includes stripping disease-caused fibers away from blood vessels. On the screen behind Chang is an angiogram of Warde's hand; the dark lines in the hand is evidence that blood is now flowing much more normally to Warde's fingers.

The surgery has been the biggest lifesaver for me. I can fully function. I feel a lot more whole than I have in quite a few years because of this surgery.

-Melissa Warde, patient, Stanford Hospital & Clinics

- Plastic and reconstructive surgery techniques have broad applications, not only to limbs and the face but also to the body’s internal regions: Abdominal walls, for example, can be reconstructed, tendons transferred and even the smallest of blood vessels restored to function.

Surgeons can also retain or restore function to the tongue, palate and esophagus as one aspect of a cancer surgery.

- Specialists in plastic and reconstructive surgery are often part of a team of physicians focused on a patient’s care and their skills incorporated into a coordinated approach to treatment.

- For many millions of people who have suffered highly disfiguring injuries or health conditions, the specialty has offered the chance at a life lived without the stares of others. For others, it has meant a life returned to normal activity.

- The field had its earliest recorded beginnings in India, around 2000 BC.

- By 1794, the first published reports appeared in an English magazine.

- In 15th century Europe, the technique was used sometimes to replace a nose lost and devoured by dogs.

- In 1827, the first American plastic surgeon repaired a cleft palate. As soldiers returned from World War I, plastic and reconstructive surgeons gained, unfortunately, experience with reconstruction of explosive- and burn-injured faces.